How to deal with the old/experienced nurses?!

nurseprnRN, BSN, RN · Dec 31, 2012

I'm sorry to be late to this party, and I do so appreciate Ruby Vee's saying what I would like to say, only nicer. hi Ruby!

Some of you know how I feel about the mindset that says everyone gets a trophy for showing up. No, you don't. Some of you know how I feel about the scorn heaped on BSN programs that "the only thing they have that we don't is a few courses on nonclinical things like research and leadership, and we don't need that to be nurses." Well, sweets, that leadership course probably included some content on team formation and dynamics, during which you would have learned how an established team reacts and adjusts to the introduction of new members, and if you were smart, would have gotten you thinking about how you would use this knowledge to your advantage.

I'm sorry you didn't have an opportunity to learn that in school, but you are, in fact, learning it now. As a matter of fact, you probably expected to learn only what students call "skills," the manipulative tasks that nurses do but that in reality can, and often are, taught to lay people all the time. That's a natural response to the check-off-based structure of a lot of nursing school. Of course, you will learn more manipulative skills, and you will polish your ability to many of them in your first year. But your most important objective must be to learn how to be socialized into the nurse role. This does not mean "how to make friends with old bags." This means how to integrate into an existing nursing team's culture.

I totally do not buy the whiny-victim "nurses eat their young," as if 1) nurses had some unique facility in making new members of the profession not get all rainbows and unicorns, or 2) the new whiplashed members were blameless and innocent victims of drive-by meanness. There is no profession with members worth their salt (which means, BTW, worth their pay) that doesn't usually have reason to look with a critical eye on newbies. As Ruby Vee says, newbies are, by definition, relatively incompetent. Therefore the more experienced members are going to have to look out for errors, proactively compensate, spend what may be precious time orienting and teaching, and hope that this time the new hire will work out. That doesn't mean they hate you; Dr. Phil his ownself says most people would be astonished at how little other people think about them at all. It means, though, that you will not be welcomed by these "old" nurses as if they were your beloved grandma happy to see you cross the threshold.

So, to distill: It is not all about you. It is about your attitude and lack of experience-- as a nurse, and as a member of the working class, and as a member of this particular team. Don't be surprised: Learn. Adapt. Observe. Watch for the little "attagirls" that will slowly come your way, if they think you deserve them. And do NOT be so sensitive, it's unbecoming. No one will chew on you if you are a bit tougher. :)

And do not call us "old." This is not just semantics. We are not trying to assuage or avoid hurt feelings by asking to be considered "seasoned" or "experienced." It's really not about "how to treat (us)." See, if you dismiss us as not worthy of your attention, or decide we have nothing to teach you, we might just ... let you drown. You don't want that, we don't want that, our patients would not do well if we did that. So ... banish the word "old" from your thoughts. Think of us as we are, seasoned by many years of experience you can't begin to guess at. Your using the "o" word dismissively is influencing you in ways that are not serving you well.

Aongroup1990, CNA · Dec 31, 2012

Just use them as a learning factor or people whom you can go to... Everyone has different moods depending on their day or maybe their own mental illness whom they forgot to get that checked before they entered nursing and sometimes many nurses may not be able to handle their own problems so vent out on others. Try not to take it personal nursing is business and serious. and should be kept that way.

OCNRN63, RN · Dec 31, 2012

Anna-s, I'm going to guess you are female - not because of your username but because from the start, your post indicates you are relationship-oriented. Most women fall into this category. You care about coming on the job and becoming a vital part of the happenings on the unit. I will tell you, as a sort of old but experienced nurse, you need to focus your energies on job performance and staying abreast of evidenced based nursing practice through trade journals and attending trade meetings for networking purposes. Many "old" and "experienced" nurses do not make a habit out of keeping their knowledge current, nor do they find the time to attend trade meetings and conferences. You can start or continue now doing this. It will go along way in helping you become not only an experienced nurse but become an expert practitioner. My opinion is that you do what previous posters have been advising you to do and not take your co-workers personal. Come in to work with an attiitude of caring, compassion, and gratitude. Meditate and pray (if you believe in that) before you go into work. Be at least civil (friendly if you can) with your co-workers as well as patients, family, and other staff and eventually you will find that you can adapt to most any work environment. Best wishes.

Where's the data to support your claim that experienced nurses don't bother to keep their knowledge current? Who do you think is doing the majority of the presentations at nursing conferences...new nurses? It's nurses with the education and experience to back up what they say.

I'm an "old" nurse who's been certified in 5 specialties throughout my career and completed over 200 hours of CEUs in the last 2y. I am not unique among my peers.

Yeah...lazy old nurse.

ColoradoRocky · Dec 31, 2012

Curious how the more seasoned RNs accept someone near their age that just finished ADN and is working way through a BSN. Male, "well over 39", married for over 2 decades, father of adult children we raised, and as soldier I have led men (and women too at times) in some difficult circumstances including giving orders that could cost us our lives. Degrees in philosophy (Logic concentration, minor in Math earned prior to service) and business (Organizational Leadership - earned while in service), Magna cum laude. I also recently got some non-military team leadership recently, running a technology test lab and team. My main medical experience (not as a patient) was as a volunteer CNA at the VA (skilled nursing facility, primarily elder vets and family), so I'm familiar with feeding, toileting, emesis basins, and the messier but personal side of patient care - for every time I cam home smelling like c-dff poo, there was also a feeling of accomplishment that I had gotten to help my patients. Yeah I had to drop my scrubs in the garage, and I was tired, but I felt better coming home like that than I ever did coming home from the business I was working in. I still remember the names and stories of several of my "regulars" who I talked to while providing care.

I know how to give orders, and also know how to take them - expect intelligence and initiative be taken from my orders and the intent behind them (i.e. thinking responses and actions, not robotic obedience), and I expect to give the same when given orders (especially given the intent behind them). Orders I don't like, I still "salute and execute", although I may argue for "why" so that I have proper context to provide proper actions. I dont have much of a tolerance of BS thrown at someone just because they are the FNG - a little hazing at first is OK, but it shouldnt get in the way of integrating them into the team. There's the right way, the wrong way, and how we do it here - the latter is most important to teach.

I'm pretty much the joker in the deck for you guys. How would you deal with a buzz cut older male like me coming onto the unit as a brand new RN (ADN) with more education and practical application on team formation, management and leadership than can be taught in any university course? Resources are managed, people must be lead; Follow Me (US Army, Fort Benning).

PRICHARILLAisMISSED · Dec 31, 2012

Kill them with kindness and try not to take it personal. No excuse but I work with older nurses everyday that are just burnt out. Sometimes nothing you do will be good enough.

There is no way in **** that I can agree with this. I'm not an RN yet, but nonetheless there are certain truths that transcend professions. Why be kind to someone that goes out of their way to make you miserable? I hate when someone (who is not your boss, just a more experienced person at your job at that) has some ridiculous perceived authority over me. Don't get me wrong, I'm all for listening to what more experienced ppl have to say if they want to "Teach the new guy," but there is no way I'll allow them to disrespect me just because they think they can.

I don't believe in that "Paying your dues **** either." I go to work to do my job-whatever that job may be-PERIOD! Not to feed some coworkers ego by being their whipping boy. Most of them are bitter because they've been doing the same thing for x amt of years because A) they are not competent enough to be promoted or B) they don't have the drive to make the necessary sacrifices to educate themselves into a better position.

OP, if you try to "Kill them with kindness" then, no offense but I hope they run all over you. Again no offense is intended and I hope you fix this, but don't be WEAK, ok?

RNfaster · Dec 31, 2012

I have worked in other areas besides healthcare. Healthcare culture is different from other cultures I have worked in. I think that healthcare culture can be negatively impacted by a history of adherence to one-way hierarchical communication, abusive communication practices, lack of patient care materials, lack of adequate staffing, pressure to work off-the-clock (not take breaks), focus on profit rather than patient care and safety. I think that these issues are at root of some of the negative behavior seen in healthcare. As such, people should not take negative behavior personally. I think hazing does go on. I think over time, people get integrated into the units and some repeat the behavior. Some don't. To get away from a negative environment sometimes requires an institutional change. It can be hard to find a place with positive practices, which is unfortunate.

Overall, I see the negative person-to-person problem as usually indicative of a cultural and institutional problem. It's also negative for the patients. I think that institutions and the people that lead them must foster change. Healthcare institutions should have open communications amongst teammates (including patients and their loved ones as part of the healthcare team), civil communications, adequate materials for patient care, and adequate staffing. Other industries don't operate on part of a shoestring like so many healthcare institutions do. Healthcare workers should demand change of their institutions.

In healthcare, I feel that many staff members are blind to the root cause of their stress and they then turn on themselves due to the pressure. Sure a new person is not going to be as competent as an established person, but that is why a floor should be staffed with seasoned staff as well as new staff. They should also be staffed adequately so that they are not terribly stressed while training the new folks. I disagree with calling a new nurse incompetent. It seems demeaning to me. They are a new nurse - not an experienced nurse. A few posts back, I posted a video from Johns Hopkins on patient safety. In one part of the video, they mentioned a resident who performed a procedure that he had not been adequately trained to do. They noted that there was in place a culture of fear (of being ridiculed for not knowing how to do something). The patient ended up dead. I think it's important for us to support new nurses and grow their skills...and to help them be unafraid to ask us for help. It's best for the patients...and ultimately will help us all to have a new nurse on our team to become an experienced nurse.

PRICHARILLAisMISSED · Dec 31, 2012

As one of the old experienced nurse, I could easily start a post entitled How To Deal With The Young Clueless Nurses. Seems there is a tendency to lump groups of people together. I can remember being new and insecure and can clearly remember the experienced nurses who helped me out and those who went out if their way to be snarky.

In the OPs case though Ma'am, it doesn't appear that she has any who are interested in helping her out. At best it looks like they just want to ignore her as a whole.

PRICHARILLAisMISSED · Dec 31, 2012

Maybe your new colleagues are sensing that you don't like or disrespect them? You start out by saying that most of your co-workers are old nurses (not OLDER) who have been on that floor for years . . . your very first sentence indicates a lack of basic respect for these nurses. In your second sentence, you've assumed that they don't like you -- and claim that you don't know why. I see nothing to indicate that you've spoken with these colleagues and they've told you they don't like you -- but if they really don't like you, one of the first things I'd consider is that they've tuned in to the fact that you don't like or respect them.
I appreciate being quiet and feeling like a stranger to the floor. I'm quiet too. Even strangers to the floor, though, can make a point of a pleasant greeting when you encounter your new colleagues. Ask them how their holiday was, and then follow up later by mentioning that you bet their son/daughter/grandchild/furry critter/whatever is enjoying/not enjoying the lovely/horrible weather while they're on school break/whatever. Be interested in them and project friendliness and interest. Even us old bats respond better to newbies who are friendly to us than to newbies who disrespect us, act as if they don't like us or avoid talking to us.
Are your colleagues actually YELLING at you? Really? Or is it just that you've received some negative feedback and are describing that as yelling? You are brand new, and should expect to receive negative feedback. Lots of it. Unless, of course, you're that rare creature who is perfect, you're going to make mistakes and it is the job of the experienced nurses on your unit to notice, point out and correct your mistakes. They'd be doing you a horrific disservice if they didn't, not to mention the disservice they'd be doing your patients. I'm not sure why it was such a big deal for you NOT to change the IV bag. If the experienced nurse told you to change it, assume that there is a reason and change it. Then make sure you understand her rationale. If, after considering her rationale for changing the IV bag early you really think she was wrong, you're free to disregard her advice and do it your way after you've been working there a year or two. But in the mean time, do it her way. She's the one with the experience.
Now in your last sentence, you say you try to talk and use humor, but they just give you "the look." I'm not sure what "the look" is, but from what you've said, you're reading minds again. Or at least you think you can. And since you stated earlier that you're not that social with your colleagues, I'm sure the "talking and using humor" takes some of them by surprise and feels incongruous.
You are the new person, entering a unit with an established culture and entrenched team. You're going to have to fit into that culture, not expect it to change for you. Part of your difficulty seems to be your lack of respect and genuine liking for your colleagues. Part of it seems to be your assumption that you know what they're thinking based on facial expressions or whatever. Part of it stems from your assumption that you know more than your experienced colleagues. And part of it seems to be an inability or unwillingness on your part to accept the inevitable negative feedback that comes with being new to a job. You can turn this around, but you have to first accept that it's not their fault. It's yours.

Everything about this is presumptuous.

Vishwamitr · Dec 31, 2012

Whoa Ruby Vee, you really shot Anna to smithereens. Poor thing was just trying to vent but she really got an earful. Lot of her statements were either misconstrued or were read into. Her post was analysed sentence by sentence like a forensic psychiatrist. I don't believe that she will ever write another post or ask for an advice because (of course, I am assuming here) she has to come a conclusion that all older nurses are the same.

Anna, nurses don't eat their young. I am not sure where that aphorism originated from but there is no credence to it. Trust me, only time will tell.

Vishwamitr · Dec 31, 2012

Correction: ....she has come to a conclusion****

tntrn, ASN, RN · Dec 31, 2012

In the OPs case though Ma'am, it doesn't appear that she has any who are interested in helping her out. At best it looks like they just want to ignore her as a whole.[/quote
It would be helpful to hear from those mean OLD nurses she works with.....you know, to get both sides of the story.

metal_m0nk, BSN, RN · Dec 31, 2012

Agreed! Those "battle axes" are the BEST nurses. They have shaped me to be an intelligent, capable, competent nurse, and a empathetic nurse...they also have helped me be able to enjoy nursing on my own terms...not much burnout, flexible and active in my career and nursing cultures when I have work-really drama and stress free...I have truly enjoyed my nursing profession, due to them...they are priceless!

Intelligent, capable, competent. Yep, I can get on board with that.

Sure, there are some who are just plain nasty to specific demographics and they feel it is their right via seniority to be. Though they may claim that their actions are a reflection of experience and an extension of mentorship, it is real easy to tell the difference.